The overall goal of this K24 renewal application is to continue to develop and implement a patient-oriented mentoring and research program in rheumatic diseases throughout the Texas Medical Center (Houston, TX). I am a rheumatologist with a PhD degree in epidemiology, and an interest in clinical epidemiology and outcomes research in musculoskeletal disorders, including comparative effectiveness, patient and physician preferences, decision-making processes, and measurement of patient reported outcomes. During the past 4 years, with the protected time offered by the K24 award, I have established a comprehensive methodological and content- based program providing mentorship and research opportunities to students, fellows, and junior physician and PhD faculty interested in pursuing independent research careers in outcomes research in rheumatic diseases. The program has encompassed various academic institutions in the Houston Texas Medical Center. The proposed continuing program is interdisciplinary, and focuses in expanding clinical research opportunities and mentoring in the field of musculoskeletal disease. Of particular interest is research in patients with rheumatic disease and various comorbidities such as cancer. I am based in the Section of Rheumatology at the University of Texas MD Anderson Cancer Center. This program is linked to the Section of Immunology, Allergy and Rheumatology at Baylor College of Medicine. We share a joint clinical fellowship program and, in addition, I also mentor Faculty and fellows at Baylor and its affiliated Veteran Affairs Medical Center. I also closely collaborate with the other academic rheumatology program in Houston, at the University of Texas Health Sciences Center. The proposed program is based on my current grants and the planned continuation projects arising from this research, including: (1) Center for Education and Research on Therapeutics, funded by the Agency for Healthcare Research and Quality (AHRQ);(2) iADAPT, an ARRA project examining the development and implementation of patient decision aids with respect to musculoskeletal conditions;(3) Utilization and toxicity of acetaminophen, a R18 grant funded by AHRQ;and (4) Quality of care for osteoporosis in patients with cancer. In addition, I am continuing my previous work, which has included many of my mentees, in treatment adherence in the rheumatic diseases, and outcomes of total knee replacement. These projects were funded by R01 grants and I am currently working on competitive renewals for these studies. These projects are the basis for the proposed mentoring and research program. The K24 award will provide me with protected time to continue to mentor others in the Houston rheumatology academic community and help them establish their independent careers in patient-oriented research in rheumatic diseases. PUBLIC HEALTH RELEVANCE: The overall goal of this K24 renewal application is to continue to develop and implement a patient-oriented mentoring and research program in rheumatic diseases in the Houston area. The proposed program is interdisciplinary, and focuses in expanding clinical research opportunities and mentoring in the field of musculoskeletal disease. This award will provide me with protected time to continue to mentor others in the Houston rheumatology academic community and help them establish their independent careers in patient-oriented research in rheumatic diseases.